This inspection took place on the 2 and 11 August 2016.Blythe House Hospice had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered provider, they are ‘registered persons.’ Registered persons have a legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Blythe House Hospice provides nursing, personal care and treatment, health diagnosis and screening associated with end of life and palliative care. A range of services were provided by the hospice to support people’s care and treatment. This included a ‘Living Well’ service (support to enhance people’s quality of life and coping strategies); an on-site walk in information and advice centre, pre-diagnosis and healthy lifestyle support, alternative therapies, bereavement and counselling support to adults and children and spiritual care. A hospice at home service was also launched in April 2016. This provided personal care to people in their own homes who choose to remain and receive care there at the end of their life.
People felt safe and their care, treatment and medicines were safely managed. People receiving care, relatives and staff knew how to raise or report any concerns they may have about people’s safety. The provider’s arrangements for staff recruitment and deployment helped to ensure people’s safe care and treatment, and related support for their relative.
People’s medicines were safely managed when required. Known risks to people’s individual safety from their health condition, environment or any equipment used for their care were regularly assessed and reviewed with them in consultation with relevant external health professionals when required. The provider’s arrangements for emergency planning, equipment and environmental maintenance and their remedial fire safety measures in progress helped to ensure people’s safety at the service.
People and their families were completely satisfied, highly complimentary and appreciative of their holistic care, treatment and support. People’s care was individually planned with them and consistently delivered to provide palliative care, treatment and alternative therapies that met with their needs and wishes. Staff worked in consultation with external health professionals when required for people’s care and treatment. This helped to optimise people’s health and comfort.
People and their families were informed and treated as equal partners in care. This was provided by a multi-disciplinary team of staff and volunteers who were trained and supported for their role and responsibilities. Approaches to learning, development and end of life care education helped to ensure people received care that met with nationally recognised standards concerned with palliative and end of life care.
Staff understood and followed the Mental Capacity Act 2005 (MCA) to ensure that people’s consent or appropriate authorisation was obtained for their care and treatment. People’s preferred priorities or advanced decisions made for their care and treatment were appropriately determined and accounted for.
People commended the quality and choice of meals provided at the day hospice. People were supported to eat food and drink they enjoyed, which met their health requirements and personal choices. Staff understood and followed people’s nutritional and related health requirements.
People and their families all spoke highly of their care and positive relationships held with staff. People felt staff treated them with the utmost care, respect, kindness and compassion and as equal partners in their care. Staff were highly motivated to make a positive difference to people’s care experience; they took time to understand how people’s illness affected their lives and what was important to them and their family for their care.
People’s rights, choices, confidentiality and involvement in their care were consistently promoted. Staff and volunteers were skilled communicators and committed ensure people were appropriately informed, involvement and empowered in care. People’s preferred care priorities and decisions about their care and treatment were appropriately shared with other care provider’s. This helped to protect people from receiving care that did not meet their needs or wishes.
People, their families and staff were provided with the multi faith spiritual, emotional and bereavement support they needed. An integrated, comprehensive range of therapeutic care, bereavement counselling, information and practical support enabled people and their families to receive the care and support they needed to live well. Motivated, caring and qualified staff and volunteers, together with suitably equipped and dedicated private space supported this. Recent national care recognition awards achieved reflected this.
The service was flexible and responsive to people needs and preferences. People received timely, flexible and individualised care tailored to their known wishes, needs and lifestyle preferences. The provider and staff communicated and engaged with people and their families in a way that met their diverse needs, was meaningful to them and helped to inform and optimise their care experience.
The service took a key role in the local community to build links and support networks for people’s care. Regular service reviews, partnership and collaborative working with external care providers and commissioners helped to ensure people and their families consistently received the right care at the right time and place.
People’s views, concerns and complaints were regularly sought, listened to and acted on. Their views about the service and those of their families, staff and volunteers were used to make improvements to people’s care when required. Further improvements were planned to introduce independent patient and staff surveys to enhance this process.
The service was well managed with an open and inclusive culture where people, their families, staff and volunteers felt recognised, listened to, valued and welcomed. Senior management and board trustees were visible and regularly engaged with people, their families and staff. Staff and volunteers were happy and proud to work at the hospice and felt they made a positive difference to people’s care experience. The registered manager’s inclusive approach; service communication and fund raising policy helped to inform service strategy and improvement.
There were clear management arrangements, lines of reporting and decision making for the operation and direction of the service. These were understood and followed by staff and volunteers who were informed, supported and supervised to perform their related roles and responsibilities.
Regular checks were made of the quality and safety of people’s care and the service environment. Where appropriate a range of local and nationally recognised standards and measures were used to inform this process. Findings from this were used to inform and make service improvements when required.
The provider ensured established links and partnership working with key external health, higher education and care providers and also relevant national bodies concerned with end of life, palliative care and treatment. This helped to influence and support cross sector care and treatment provision, staff education, care practice, strategic planning and service improvement. Service planning took account of financial viability, work force planning considerations, local population and related health demands; to help inform and ensure the quality and shape of Blythe House Hospice service.